On Medicare panel, Pescovitz highlights role of academic medicine

By Kara Gavin
UMHS Public Relations

What’s the future of Medicare? With 49 million Americans getting their health care through the program, 16 percent of all federal spending going toward it, and millions of baby boomers becoming eligible every year, that question matters more than ever.

Ora Hirsch Pescovitz

On Wednesday in Washington, D.C., Dr. Ora Hirsch Pescovitz, executive vice president for medical affairs and CEO of the U-M Health System, and other top national health leaders discussed what it would take to make Medicare sustainable and robust for the future.

In a symposium at the National Press Club organized by the Medicare News Group, she and her fellow panelists tackled some of the thorniest questions surrounding Medicare in front of an audience of national reporters and others.

She said one thing is for certain: Academic medical centers such as UMHS are vital to improving the care that Medicare participants receive, enhancing the health of older and disabled Americans, and containing the growth of Medicare costs.

Academic centers, she said, all share a goal of providing primary and advanced care, training new physicians and other health professionals, and performing research to improve care now and in the future.

But these teaching hospitals and medical schools also are highly vulnerable when lawmakers cut the federal Health & Human Services budget, including through the recently implemented sequestration measures, she said.

Such cuts hit academic centers as a ‘triple whammy,’ affecting hospital and physician reimbursement for the care of Medicare participants, graduate medical education funds that Medicare provides for training new physicians, and research funding from the National Institutes of Health and other agencies.

At the same time, academic centers are among the first in line to take part in Medicare efforts that reward better clinical performance, higher quality and cost containment.

A case in point is the number of Accountable Care Organizations that academic medical centers have launched or are participating in, to coordinate the care of Medicare participants across hospitals, clinics and other types of care.

UMHS has launched two ACOs, Pescovitz noted — one for U-M Faculty Group Practice physicians and the doctors of the IHA physician group, and one for 1,800 physicians from nine physician groups across lower Michigan called POM ACO.

Pescovitz noted that ACOs are still in their early, experimental stages. But, she said, the UMHS experience in a Medicare demonstration project that led to the development of ACOs helps show that it is possible to improve care and contain costs in Medicare at the same time.

In addition to Pescovitz, panelists included:

• Tom Scully, former director of the Centers for Medicare and Medicaid Services, the federal agency that oversees the Medicare system.

• Robert Berenson, senior fellow at the Urban Institute and former vice chair of the Medicare Payment Advisory Commission.

• Susan DeVore, president and chief executive officer of the Premier hospital alliance.

• Sally Greenberg, executive director of the National Consumers League.